自身抗体联合检测诊断系统性红斑狼疮的价值分析  

Value of Combined Detection of Autoantibodies in Diagnosis of Systemic Lupus Erythematosus

作　　者：杨玉芹[1] YANG Yu-qin(Department of Laboratory Medicine,Huai'an First Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu Province,223300 China)

机构地区：[1]南京医科大学附属淮安第一医院检验科

出　　处：《系统医学》2019年第24期51-53,共3页Systems Medicine

摘　　要：目的研究自身抗体联合检测诊断系统性红斑狼疮(SLE)的价值。方法选择2017年1月-2019年1月该院收治的疑似SLE患者142例作为观察组,另选取同期体检健康者30名作为对照组。所有入选者均行抗双链DNA抗体(抗dsDNA)、抗核小体抗体(ANUA)、抗核抗体(ANA)及抗SM检测,并与其经临床表现、实验室检查、组织病理学检查、影像学检查的最终确诊结果做对比分析。结果观察A组(SLE)、观察B组(其他免疫系统疾病)及对照组自身抗体阳性率比较,差异有统计学意义(P<0.05);观察A组抗dsDNA、ANUA、抗SM阳性率(46.34%、21.95%、25.61%)均高于观察B组(5.00%、6.67%、0.00%),差异有统计学意义(χ^2=28.835、6.182、18.033,P=0.000、0.013、0.000);4种自身抗体单独检测和联合检测诊断SLE的敏感性、特异性及准确度比较,差异有统计学意义(P<0.05);联合检测诊断SLE的准确度(97.89%)高于4种自身抗体(抗dsDNA、ANUA、ANA、抗SM)单独检测诊断准确度(71.13%、70.42%、66.90%、64.08%),差异有统计学意义(χ^2=38.835、40.164、46.994、52.684,P=0.000、0.000、0.000、0.000)。结论ANA检测诊断SLE敏感性较高,特异性较低,可作为筛查项目,抗SM检测具有高度特异性,可用于SLE与其他自身免疫性疾病的鉴别诊断,ANUA、抗dsDNA的特异性均较高,因此研究中4项自身抗体检测在SLE诊断方面均有一定价值,且联合检测可进一步提升诊断准确度。Objective To study the value of combined detection of autoantibodies in the diagnosis of systemic lupus erythematosus(SLE).Methods From January 2017 to January 2019,142 patients with suspected SLE who were admitted to the hospital were selected as the observation group,and 30 healthy patients who were examined during the same period were selected as the control group.All selected candidates were tested for anti-double-stranded DNA antibodies(anti-dsDNA),anti-nucleosome antibodies(ANUA),anti-nuclear antibodies(ANA),and anti-SM.The clinical manifestations,laboratory tests,histopathological examinations,the final diagnosis results of imaging examination were compared and analyzed.Results There was a statistically significant difference in the positive rates of autoantibodies between group A(SLE),group B(other immune system diseases),and the control group(P<0.05).Observation group A anti-dsDNA,ANUA,and anti-SM positive rates(46.34%,21.95%,25.61%)were higher than those of observation group B(5.00%,6.67%,0.00%),and the differences were statistically significant(χ^2=28.835,6.182,18.033,P=0.000,0.013,0.000);There were significant differences in the sensitivity,specificity,and accuracy of 4 individual autoantibodies for the detection of SLE(P<0.05);the accuracy of the combined detection of SLE(97.89%)was higher than that of the four autoantibodies(Anti-dsDNA,ANUA,ANA,anti-SM)detection accuracy(71.13%,70.42%,66.90%,64.08%),the difference was statistically significant(χ^2=38.835,40.164,46.994,52.684,P=0.000,0.000,0.000,0.000).Conclusion The ANA test has high sensitivity and low specificity in the diagnosis of SLE.It can be used as a screening item.Anti-SM test is highly specific and can be used for the differential diagnosis of SLE and other autoimmune diseases.The specificities of ANUA and anti-dsDNA are both high,so the four autoantibody tests in the study have some value in the diagnosis of SLE,and the combined detection can further improve the diagnostic accuracy.

关 键 词：系统性红斑狼疮 自身抗体 阳性率 敏感性 特异性 

分 类 号：R593[医药卫生—内科学]